Nebraska Legislature - Lobbyist Reporting Application

FORM
A

NEBRASKA LEGISLATURE
APPLICATION FOR REGISTRATION AS A LOBBYIST

Jan 24, 2019

Clerk of the Legislature
Room 2014, State Capitol
PO Box 94604
Lincoln, NE 68509-4604
Phone: (402) 471-2608

For Calendar Year of:

Amended Registration

Lobbyist Registration Fee:
{49-1480.01}

Compensated

$200.00

(If you are a salaried employee of your principal, you are a compensated lobbyist.)

Not Compensated

$15.00

PLEASE FILL IN ALL BLANKS

LOBBYIST {49-1480(1)}

Name

Bromm, Jason

Office Address (Street, Box, or Route)

635 S 14th Suite 315

Permanent Residence (Street, Box, or Route)

10506 S. 179th Street

City

Lincoln

State

Zip

68508

City

Omaha

State

Zip

68136

Office Phone

(402) 327-1603

Home Phone

Email Address

jb@bnmlobby.com

PRINCIPAL {49-1480(2)}

Name

Bromm Nielsen & Mines

Office Phone

(402) 327-1603

Office Address (Street, Box, or Route)

635 S 14th Suite 315

Official to Whom Lobbyist is Accountable

City

Lincoln

State

Zip

68508

Nature of Business {49-1480(3)}

Government Relations

AMOUNTS GIVEN or to be given to lobbyist as compensation or reimbursement of lobbying: {49-1480(3)}. Please state the basis for your compensation.
0.00 Percentage of salary

IDENTIFICATION of MATTERS on which principal or lobbyist expects to lobby: {49-1480(5)} All matters of interest to the principal

Description of industry, trade, profession, or interests and groups represented by the principal:

Names and addresses of principal's officers:

GIVE NAME and ADDRESS of any OFFICIAL in the Legislative or Executive Branch and of any members of any such official's staff or immediate family who is employed by you or by anyone acting on your behalf: {49-1480(8)}

I certify that all information presented in this form is accurate to the best of my knowledge.

Bromm, Jason

Lobbyist Name

Jan 24, 2019

Date